Health Insurance Changes

Each year employees enrolled in one of the State Group Health Insurance plans have the opportunity to change from one health insurance carrier to another, or to add eligible family members who are not presently covered.  This year, the Dual Choice enrollment is from October 9 through October 27.  The effective date of any change is January 1, 2007. 

To help employees assess their current health care plan and determine the need to make changes in coverage, the Office of Human Resources is providing the following checklist:

• Is my plan still available? If not, have I selected a new plan and completed the application?

• Is my physician, clinic, or hospital still affiliated with my plan?

• Are there sufficient providers, including specialists, conveniently located?

• Have benefits changed with my plan?

• Has the premium for my plan changed?

• Does my plan include dental coverage?

• Am I satisfied with my plan?

• Do I want to change from single to family coverage for 2007?

• Have I reviewed the Dual Choice Booklet (booklets being sent out week of October 9)?

• Have I checked which Tier my plan is in for 2007?

• Am I changing plans?  If so, have I submitted an application to Human Resources?

Applications are due in the Human Resources office no later than 4:30 p.m. on Friday, October 27, 2006. 

What are the major Dual Choice changes?

• Security Health Plan is back.  Security provides coverage in Eau Claire, Chippewa, Clark, and Pepin counties, as well as coverage in other counties outside our local region.  They are in Tier 1.  Check out their providers on page G-35 of the Dual Choice booklet, or online at www.securityhealth.org under "visitors."

• Standard Plan and Standard Maintenance Plan (SMP) will be administered by Wisconsin Physician Service (WPS) again this year.  If you wish to remain with the Standard Plan or SMP, you are not required to complete a new application.  Check the provider list at www.wpsic.com/state.  (Please note that SMP is not available in most counties, but is still available in Pierce and Pepin counties.)

• Pharmacy Benefit Manager.   Again in 2007 there will be one drug formulary for all state employees.  Please refer to http://www.navitushealth.com for a complete drug formulary.

• Premium Rates for 2007  For calendar year 2007 employee share for premiums will be as follows:

Prescription co-pay amounts ($5.00, $15.00, and $35.00) will remain the same in 2007.  However, the out-of-pocket maximum will increase to $320.00 per individual, and $640.00 per family for most plans.  (Don't forget that the Employee Reimbursement Account allows prescription co-pays as a medical reimbursement item.)  Standard Plan out-of-pocket maximums remain at $1,000.00 per individual and $2,000.00 per family.

Dual Choice Booklets will be sent to all currently covered employees during the week of October 9th.  The booklet contains important information about changes in uniform benefits, prescription drug coverage, and provider network changes.  Booklets will be distributed through campus mail.  Anyone with questions about insurance coverage or anyone considering a change is encouraged to meet with representatives at the Benefits Fair scheduled for October 18, 2006.

A complete list of notable plan and program changes may be found in the “It’s Your Choice” 2007 Dual Choice Booklet at http://etf.wi.gov/publications/et2107_2007.htm. 

Benefits Fair

Wednesday, October 18, 2006

11:00 a.m. - 3:00 p.m.

Tamarack Room of Davies Center 

The following vendors/representatives will be attending:

Health Insurance

*  CompcareBlue Northwest

*  Group Health

*  Humana Western

*  Security Health Plan

*  WI Physicians Svcs (WPS)

Hospitals

*  Luther Midelfort

*  Marshfield Clinic

*  Sacred Heart

*  Oak Leaf Medical

Optional Vision Insurance           

*  Spectera

Long-Term Care               

*  Health Choice

*  Senior Care Insurance Svcs

ERA (Employee Reimbursement Account)

*  Fringe Benefits Management Co.

Dental Insurance

*  DentalBlue 

Other Enrollment Information

To participate, you must be eligible for immediate or future employer contribution to the health insurance program.  This includes the following employees and their dependents:

• unclassified staff

• classified staff (including LTE's eligible for Wisconsin Retirement)

• graduate assistants

Domestic partners and their children are eligible under this plan.

Rehired annuitants receiving a Wisconsin Retirement System annuity are not eligible for this program.

Open enrollment for Spectera Vision insurance is October 9 - November 17, 2006.  Applications must be submitted to the Human Resources office by 4:30 p.m. on Friday, November 17, 2006.  Coverage will be effective on January 1, 2007.  Premiums will be deducted from your paycheck on a pretax basis.

Spectera Vision Insurance information will be sent to all eligible employees through campus mail.

ERA enrollment is scheduled from October 9 through November 17, 2006.  Information is being sent through campus mail.  The booklet explains online enrollment procedures.

Medical and child care expenses for services provided through March 15, 2007, may be reimbursed with funds remaining from 2006 plan year.  However, any unused amounts from the prior plan year that are not used for expenses incurred by March 15 remain subject to the "use it or lose it" rule and will be forfeited.

The deadline (or "run-out" period) for filing both medical expense and dependent care claims incurred during the plan year, as well as medical expenses incurred during the grace period, will be April 15, 2007.

Are you planning to retire in 2007?  If so, you may want to have your entire annual contribution amount withheld from the number of checks you will receive in 2007 so you can take advantage of the pretax benefit for the entire calendar year.  Contact Donna Weber (36-4323) for assistance if necessary.

Faculty and Teaching Academic Staff only:  You must have your annual contribution withheld from nine checks.  ERA contributions are not taken out during the summer, even if you are receiving paychecks during the summer.

*  DentalBlue/Dentacare Plans

Dentacare plans are offered under two separate contracts.  One is sponsored by UW System and the other is sponsored by the Office of State Employment Relations (OSER). 

• October 9 - 27, 2006 is open enrollment period for both the UW System and the Office of State Employment Relations (OSER) sponsored DentalBlue Plans which includes Dentacare HMO, Dentacare PPO, and the Supplemental Plan. 

• Coverage will be effective January 1, 2007.  To enroll in Dentacare, employees must be eligible to enroll in the State of Wisconsin group health insurance program with either an immediate or future state share contribution.

• If you are already covered under any of the above plans, the annual change opportunity also runs from October 9 - 27, 2006.  During this period you can add eligible dependents or change to a different DentalBlue plan.  Coverage changes will be effective January 1, 2007.

• The Supplemental Plan is available to anyone who already has some dental coverage provided by their participating health plan.

UW System sponsored plan:

Unclassified staff, non-represented classified staff (including LTE's covered by the retirement system), and graduate assistants are eligible to enroll for single, employee + 1 or family coverage.  Rehired annuitants are not eligible.

OSER sponsored plan:

All represented classified employees are eligible for single, employee +1 or family coverage.

Important Note:  The UW System and OSER plans are virtually identical; however, represented employees must enroll in the OSER sponsored plan.

Watch for more information coming soon.

*  Dependent Coverage for Health Insurance

If you have dependents who are over 19 and are still covered under your health insurance plan, your health insurance company will be mailing out Student Status forms.  They will arrive in your mail in late October, and are due back to the health insurance company by December 1.  It is crucial to complete and submit the forms in a timely manner.  Coverage for your dependents could be jeopardized if you ignore the form.  Employees must submit the student status information to their current insurance company, even if they plan to change plans during the Dual Choice Enrollment period.  Your current company will forward the completed plans appropriately. 

Questions regarding Dual Choice may be directed to the Office of Human Resources at 36-3871.